The uptake of cervical cancer screening by renal transplant recipients.
BACKGROUND
Renal transplant recipients are at an increased risk of developing cervical cancer compared to women in the general population. At least annual cervical smear screening is currently recommended, but little information is available regarding the actual uptake of such screening.


METHODS
All female renal transplant recipients in one United Kingdom region who were alive with a functioning graft were identified. The uptake and results of cervical smear testing over a 10-year period in this cohort were determined.


RESULTS
Of the 173 women eligible for cervical cancer screening, 18 (10%) undertook the recommended number of screening procedures; 56 (32%) had never had a cervical smear performed. The year of transplantation, age at engraftment and the social deprivation status did not significantly influence the uptake of screening (P > 0.05). In those women who were screened, the incidence of smear test abnormalities was 20% in renal transplant recipients compared with 7% in the general population. The cytological findings in the positive smear tests ranged from borderline changes to grade III cervical intraepithelial neoplasia.


CONCLUSIONS
The renal transplant population is at higher risk of abnormal cervical cytology, but the uptake of cervical cancer screening is low. The reasons for this low screening rate are unclear, and changes in practice are necessary to improve the uptake of cervical smear testing in women with renal transplants.
Courtney
Aisling E
AE
Regional Nephrology Unit, Belfast City Hospital, Belfast, BT9 7AB, UK. aecourtney@doctors.org.uk
Leonard
Niall
N
O'Neill
Ciaran J
CJ
McNamee
Peter T
PT
Maxwell
Alexander P
AP
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000523:psychology; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009660:Northern Ireland; D010349:Patient Compliance; D012307:Risk Factors; D012923:Social Class; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000209:etiology*; D014626:Vaginal Smears / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult